叙事医学“要旨”之追问:努力“复原真相”?

Question the“Essence”of Narrative Medicine:Efforts to“Restore the Truth”?

叙事医学的本质是对注重充分搜集患者信息的临床诊疗传统之回归。其最核心要点在于尽可能探寻"疾病真相"。叙事医学之诞生,与20世纪现代主义盛行,一切讲究证据的纯科学主义思潮有关,它源于历史学的"宏大叙事"和"叙事理论",直接承启了20世纪80年代叙事心理学之学派。要发展叙事医学,可以分通俗路线和专精路线,前者类似于"通俗"唱法,鼓励临床医师为了探究疾病真相,不拘一格,学会听故事、讲故事;后者则类似于"美声"唱法,讲究一定的仪式/程序(如平行病历等),遵循学院式的范本。叙事医学强调当今似应大力促进临床医师注重对话交流(问诊)传统,不拘仪式/程序,学会听/讲故事,借此更好地了解具体到每个人的个性化疾病故事,甚为重要。

The author believes that the essence of narrative medicine is the renaissance of the clinical diagnosis and treatment tradition that emphasizes on the full collection of patient information.The core focus is to explore the＂underlying truth of the disease＂as much as possible.The birth of narrative medicine,is influenced by the uprising of modernism in the twentieth century,entirely reliant on the evidence-based pure scientific principle.This originates from the history of the＂grand narrative＂and＂narrative theory＂,the direct narrative psychology of the 80 sera academia.In view of this,the author emphasizes that the development of narrative medicine,can be divided into popular approach and specialized approach.The former is akin to the popular singing,encourages clinicians not to be confined to formalities and explore the underlying cause of disease,to learn to listen and tell the stories.The latter is similar to bel canto,which follows customs and procedures（such as medical records）,and adheres to medical college standards.Therefore,nowadays,it is more important to encourage clinicians to focus on communications and interactions with patients.